A class of recently developed medications for schizophrenia has rapidly become psychiatrists' treatment of choice. Small, pharmaceutical company–funded trials had suggested that the drugs are safer and more effective than a generation of antipsychotic substances that has been used since the 1950s.
A new federally funded study of unprecedented size and length calls into question that conclusion. One of the older medications alleviates schizophrenia symptoms about as well as three of the newer, so-called atypical antipsychotics do, say psychiatrist Jeffrey A. Lieberman of Columbia University and his colleagues.
A fourth atypical antipsychotic, olanzapine, yielded slightly more reduction in symptoms than the other drugs did. However, 9 percent of those receiving olanzapine experienced substantial weight gain and metabolic disturbances that can cause diabetes and shorten life, more than twice the proportion for any other drug in the study.